Recent content by lphillips

  1. L

    Medical decision making for obstructive sleep apnea

    Medical Decision Making is made up of multiple components - so there is no way to actually answer your question as posted. Number of Diagnosis/Management Options; Amount and/or Complexity of Data Reviewed and Risk of Complications, Morbidity, Mortality (Table of Risk) all need to be taken into...
  2. L

    Need advice regarding E&M upcode

    The provider only needs to meet the requirements for either '95 or '97 guidelines, they do not have to meet both. If provider documentation supports a higher level of service then what "they selected", it is not a bad or wrong thing to correct it appropriately. Under coding is just as bad as...
  3. L

    Need help with Clarix amniotic membrane graft

    I am having a hard time finding a code for the placement of a Clarix amniotic membrane graft. I have two encounters: 1st - Clarix amniotic membrane graft inserted intraarticularly and subcuticulary and first MTP for reduction of inflammation, joint surface tissue formation. 2nd - Clarix...
  4. L

    Help with code for Clarix membrane graft

    I am having a hard time finding a code for the placement of a Clarix amniotic membrane graft. I have two encounters: 1st - Clarix amniotic membrane graft inserted intraarticularly and subcuticulary and first MTP for reduction of inflammation, joint surface tissue formation. 2nd - Clarix...
  5. L

    Infection of Hip hemiarthroplasty

    Look to the 27134 area for the revision, I'm thinking the irrigation and debridement might be included.
  6. L

    Coding Radius/Ulnar FX of differing locations

    :confused:Hope someone can help me with this. The provider performed ORIF of proximal radial fracture and ORIF of midshaft ulnar fracture. My conundrum is the following: Would the fractures be coded out separately as they are in differing areas (813.17, 813.32). Or would I use a Radius with...
  7. L

    Help with CPT for repair nonunion/malunion sacrum fracture

    I am looking for a CPT code to capture the Repair, nonunion or malunion, sacral. All I am finding is for the initial fracture repair. In addition, the provider removed prior fixation device and in my research I am showing that he can charge for the removal of the earlier placed hardware in...
  8. L

    FB in arm

    I would code 729.6 and a V-code. You didn't state that it was a new wound and residual is "something left over". Hope this helps!:)
  9. L

    need help please

    I don't see any reason why the surgeon could not bill an inpatient consultation, as long as the specific criteria regarding consultations is documented properly and the patient is not Medicare. If the patient is Medicare than I would look to the subsequent services 99231-99233.
  10. L

    Can I bill an E&M?

    Where there any issues found with the patients blook work? Where any medications or treatments prescribed?
  11. L

    Help - hospital side

    Don't know if this will help or not but here goes. Per CPT guidance - Do not report 92133 and 92134 at the same patient encounter. Per Encoder Pro - You can bill either 92133 and 92250, or 92134 and 92250 and modifier -59 would be appropriate.
  12. L

    Wiki Hyponatremia-resolved

    The patient is still admitted and the issues have resolved? Would query what else is going on. Are they still monitoring the issues?
  13. L

    Coding blood in stool with GI bleed diagnoses

    Thanks for you input!
  14. L

    Coding blood in stool with GI bleed diagnoses

    :oProvider diagnoses, GI bleed and blood in stool. Would you code both 578.9 and 578.1? Or just 578.9 because 578.1 is a symptom of? I believe the 578.1 helps to give a better description of the issue. Blood in stool is visible, where as say, 792.1 occult blood is not visible and is found...
  15. L

    Coding blood in stool with GI Bleed

    Provider diagnoses, GI bleed and blood in stool. Would you code both 578.9 and 578.1? Or just 578.9 because 578.1 is a symptom of? I believe the 578.1 helps to give a better description of the issue. Blood in stool is visible, where as say, 792.1 occult blood is not visible and is found during...
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